Improving patient emotional functioning and psychological morbidity: Evaluation of a consultation skills training program for oncologists

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• 作者：Afaf Girgis ; Jill Cockburn ; Phyllis Butow ; Deborah Bowman ; Penelope Schofield ; Elizabeth Stojanovski ; Catherine D’ ; Este ; Martin H.N. Tattersall ; Christopher Doran ; Jane Turner
• 关键词：Cancer ; Oncology ; Communication skills ; Randomized-controlled trial ; Patient outcomes
• 刊名：Patient Education and Counseling
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：77
• 期：3
• 页码：456-462
• 全文大小：175 K

文摘

Objective

To evaluate whether a consultation skills training (CST) program with oncologists and trainees would improve skills in detecting and responding to patient distress, thereby improving their patients’ emotional functioning and reducing psychological distress.

Methods

Randomized-controlled trial with 29 medical and radiation oncologists from Australia randomized to CST group (n = 15) or usual-care group (n = 14). The CST consisted of a 1.5-day face-to-face workshop incorporating presentation of principles, a DVD modelling ideal behaviour and role-play practice, and four 1.5 h monthly video-conferences. At the CST conclusion, patients of participating doctors were recruited (n = 192 in CST group, n = 183 in usual-care group), completing telephone surveys at baseline, 1 week and 3 months to assess quality of life, anxiety, depression and unmet psychosocial needs.

Results

Despite high patient functioning at baseline, anxiety significantly improved at 1-week follow-up in the CST group, compared to the control group. There were no statistically significant differences in emotional functioning, depression or unmet supportive care need between the groups.

Conclusion

Consistent trends for greater improvements were observed in intervention compared to control group patients, suggesting the CST program deserves wider evaluation.

Practice implications

Video-conferencing after a short training course may be an effective strategy for delivering CST.